Saturday, August 11, 2012

1036. Sunday Aug 12, 2012. Loss of confidence in a vet

Sunday's interesting cases
Aug 12, 2012

Case 1
Bright sunshine. I came to work at 8.15 am as Mr Min took Sunday off at 7 am.
I had an appointment as the lady of a biting chihuahua, female, spayed, 14 years old decided to get dental work done. This was the first sister. She wanted me to do the dental on her dog and no other associate vet here to do it.

"Why?" I asked this fair lady of around 30 years of age, arriving in a taxi so early on Sunday morning. "My associate vets can do dental too."
"Because you are experienced. Because, Kiki is very precious to me."

She lived quite close to a vet practice but would not go there. Two years ago, she went to a big practice but she had to go back twice to treat her dog's dental problems as the vet missed the oro-nasal fistula at the first visit. So her father, her sister and she tried my services on Nov 4, 2011.

Her sister's dog, Teddy had bad breath and decayed fractured maxillary Right canine.
Dental scaling and 8 teeth extracted. I checked my case sheet and the following anaesthetic record was given to her sister:

Nov 4, 2011  Teddy, Terrier X, 4.6 kg, 39.2C
Bad breath & decayed fractured canine R maxillary
AMA - does not want blood test
11.05 am  xylazine 0.1 ml IM. Wait 10 min.
11.16 am  isoflurane + O2  1% intubated
11.29 am  isoflurane + O2 1% maintenance
11.32 am   isoflurane + O2  0.5%
11.35 am  end of dental. wakes up fast.
Post op tolfedine + baytril, trimeth + multivit.

Whole dental work process   11.35 am - 11.05 am = 30 minutes
Isoflurane used =   11.35 am - 11.16 am = 19 minutes

Today, 9 months later,  I phoned the owner of Teddy. No dental problem.  As for Kiki who came today, the owner agreed to do a blood test first. Now this was a biting dog. How to do it efficiently?

"Be gentle. The last time your vet did it," the lady said. "She had to take blood from 4 legs! This is because her veins are very thin."

I was surprised. "Normally one leg will do."    
I told Dr Daniel to get a tourniquet.
"Shave the cephalic vein area," I said. "You can see the vein better.
A tourniquet, muzzle and shaving the vein area enable Dr Daniel to draw blood in sufficient amounts. But the dog shot out several stools and peed. I gave antibiotics for 7 days and will do the dental next Sunday.

Case 2. Surprisingly, one lady phoned to say that her dog was on heat. The dog was spayed as a 6-month-old in Aug 2011. The vet had told her that the left ovary could not be found and to phone if the dog was on heat. So, now, almost one year later, the dog was on heat and she asked:"When should I get the dog spayed?"


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